Surgical control device for controlling operating means inserted into a body cavity



p 1959 P. HILZINGER in 2,905,178

SURGICAL CONTROL DEVICE FOR CONTROLLING OPERATING MEANS INSERTED INTO ABODY CAVITY Filed Dec. 19, 1956 xfuir} u .if/M

United States Patent SURGICAL CONTROL DEVICE FOR CONTROL- LING OPERATINGMEANS INSERTED INTO A BODY CAVITY Paul Hilzinger HI, Tuttlingen,Wurttemberg, Germany Application December 19, 1956, Serial No. 629,334Claims priority, application Germ any December 20, 1955 8 Claims. c1.128-303) The present invention relates to a surgical control devicewhich permits operating means inserted into a body cavity to becontrolled by the surgeons manipulation of hand controls located outsidethe body cavity.

In practice, such control devices must be curved to follow bodypassages. Guides for surgical control devices according to the prior arteither are rigid or they are insufficiently durable to permit repeatedbending thereof between a plurality of desired curved positions.

Y It is an object of the present invention to avoid the disadvantagesinherent in surgical control devices according to the prior art.

It is a further object of the present invention to provide for asurgical control device a tubular guide which permits of repeatedbending to desired curved positions without damage.

It is another object of the present invention to prevent folding orbreaking of the tubular guide for the surgical control device byrepeated bending to different shapes.

Another object of the present invention is to provide a surgical controldevice which is bendable yet durable and which can be safely inserted ina body cavity in contact with body tissue.

vA further object of the present invention is to provide bendable guidemeans for a surgical control device which can be manufactured atreasonable cost and which can be assembled and easily maintained in goodoperating condition.

Yet another object of the present invention is to provide a surgicalcontrol device which makes efficient and economical use of the veryexpensive materials required for such devices.

Another object of the present invention is to provide a surgical controldevice which can be connected interchangeably with any number ofdifierent operating means and control handles.

Yet another object of the present invention is to provide a surgicalcontrol device which meets the aseptic requirements for use in livingbeings. j

Another object of the present invention is to provide a surgical controldevice, such as a valvulotome, which is certain and reliable inoperation and which is especially suitable for delicate heartoperations.

Another object of the present invention is to provide a surgical controldevice which permits the surgeon to control pressure of the operatingmeans during movement into the body cavity and also during movementoutward from the body cavity.

With the above objects in view the present invention mainly consists ina surgical control device comprising a bendable tubular guide means, anelongated instrument control means passing through the tubular guidemeans and being movable relative thereto, and at least one coil springmeans tightly engaging the tubular guide means along the length thereofwhereby the bendable guide means can be repeatedly bent betweendifferent desired curved positions without being damaged.

The word bendable as used herein refers to a type of flexibility whichpermits bending from one position to another desired position along thelength of the guide means and which permits retention of said guidemeans in a desired bent position during use of the device for operatingin a body cavity, or at least until the surgeon again bends or variesthe curvature thereof during use or otherwise.

The novel features which are considered as characteristic for theinvention are set forth in particular in the appended claims. Theinvention itself, however, both as to its construction and its method ofoperation, together with additional objects and advantages thereof, willbe best understood from the following description of specificembodiments when read in connection with the accompanying drawings, inwhich:

Fig. 1 is a side view of one embodiment of the present invention;

Fig. 2 is a fragmentary side view partly in section of the area A inFig. 1;

Fig. 3 is a fragmentary side view partly in section of the area B onFig. 1;

Fig. 4 is a sectional view taken along the line 44 of Fig. 1;

Fig. 5 is a fragmentary side view partly in section of a modified formof the embodiment of Figs. 14; and

Fig. 6 is a sectional view taken along the line 6-6 of Fig. 5.

With reference to the drawings, Figs. 1-4 show a thinwalled tubularguide means indicated generally by the numeral 12 and having a pair ofspaced end portions 2a and 2b and intermediate portions 20, 2d and 2e.The end portions 2a and 2b and the portion 2d are cylindrical, theportion Be is flattened, as can be seen particularly in Fig. 4, and theportions 2c are tapered and interconnect the flattened portions 2e withthe adjacent portions 2a and 2d. At least the portion 2e of guide means12 is composed of material having a flexibility which permits the userto bend this portion 2e and to use the device with the portion 22retaining or maintaining this bent condition. The material permits,also, that the portion 22 can be repeatedly bent between differentdesired curved positions. The guide means 12 has a pair of end faces 12aand 12b shown respectively in Figs. 2 and 3.

An elongated instrtunent control means indicated generally by thenumeral 11 passes through the tubular guide means 13 and is movablerelative thereto. The control means 11 includes a first end portion 10,shown in Fig. 2, which is threaded and adapted to be threadedlyconnected to operating means, such as operating means 11a fragmentarilyshown in Fig. 2. The control means 11 has also a second end portion 10,shown in Fig. 1 as including ball joint means 11c for connecting thecontrol means 11 with manually operable means (not shown) forcontrolling the operating means 11a. The end portions 1a and 1c connectthe control means 11 interchangeably with a variety of operating meansor instruments and with operable means or control handles.

The control means 11 includes a portion 12, shown in Fig. 4, which has across-section corresponding in shape with the flattened portion 2e ofthe guide means 12, a a cylindrical portion 1d located adjacent theportion 1e, and a cylindrical portion 1b which is thicker than theremainder of the control means 11 and is located between the portions 1aand 1c and opposite the end portion 217 of the guide means 12.

A coil spring means, indicated generally by the numeral 13 and composedof non-magnetizable material, tightly engages the tubular guide means 12along the length thereof to prevent damage thereto during repeatedbending. The spring means 13 has ends 3a and 3b which may be connectedto the guide means 12 at the end POI. tions 2a and 2b respectively.

In the embodiment illustrated, a pair of end members 4 and are providedas shown in Figs. l-3, to which the ends 3a and 3b of the spring means13 are connected. Theend members 4 and 5 have, respectively, radiallyextending annular stop portions 4a and 5b to which the ends 3a and 3b ofthe spring means 13 are fixedly connected, for example, by welding.

The intermediate portions 3c, 3d and 3e of the coil spring means 13correspond in shape with the portions 2c, 2d and 2e, respectively, ofthe guide means 12.

As shown in Figs. 2 and 3, the end members 4 and 5 include,respectively, portions 14a and 15b which provide for each of these endmembers 4 and 5 a pair of cylindrical surface portions which engage thewalls of the respectively adjacent end portions 211 and 2b of the guidemeans 12. The portions 14a and 15b provide also for each of these endmembers 4 and 5 a pair of end faces which abut the end faces 12a and 12bof the respectively adjacent end portions 2a and 2b of the guide means12.

One end member or both end members 4 and 5 may be turnable relative theguide means 12. Advantageously, the end member 5 is so turnable.

As shown in Fig. 2, the first end portion 1a of the control means ormember 11 extends axially beyond the first end portion 2a of the guidemeans or tubular member 12. The second end portion 1b of control means11 extends axially beyond the end member 5, as shown in Fig. 3.

The stop portion 4a is located axially beyond the end portion 4 and thestop portion 512 is located axially inward of the end face 12b as shownin Figs, 2. and 3, respectively. The thicker portion 1b of the controlmeans 11 extends to a point axially inward of the stop portion 5b.

The outer wall of the thicker portion 1b of the control means 11contacts the inner wall of the end portion 2b and the inner wall of theend member 5 so that movement of the control member 11 is guided.

In the modification illustrated in Figs. 5 and 6, the guide means 7 iscylindrical throughout and is not flattened as is the guide means 12.Coil spring means 6 and 8 are provided and tightly engage the inner andouter walls, respectively, of the guide means 7. The control means 11 isas that of the device illustrated in Figs. l-4 except that it is notflattened but is of cylindrical shape for the whole length thereofwithin the guide means 7.

At least those portions of the device which enter the body and contactbody tissues are made of silver or similar materials which do notadversely affect body tissues and which may even promote healing. Thecoil spring means 13 is preferably of non-rusting, non-magnetizablematerial, such as, for example, stainless steel wire.

The end portion 1a of the control means 11 can be interchangeablyconnected with operating means of medical instruments such as, forexample, punches, mastoid rongeurs, dilators, forceps, conchotomes, andvalvulotomes. The portions and 110 of the control means 11 connect saidmeans 11 either movably or fixedly with interchangeable handles orcontrol grips.

It will be understood that each of the elements described above, or twoor more together, may also find a useful application in other types ofmanually operated control devices differing from the types describedabove.

While the invention has been illustrated and described as embodied in asurgical control device having a bendable guide, it is not intended tobe limited to the details shown, since various modifications andstructural changes may be made without departing in any way from thespirit of the present invention.

Without further analysis, the foregoing will so fully reveal the gist ofthe present invention that others can by applying current knowledgereadily adapt it for various applications without omitting featuresthat, from the 4 standpoint of prior art, fairly constitute essentialcharacteristics of the generic or specific aspects of this inventionand, therefore, such adaptations should and are intended to becomprehended within the meaning and range of equivalence of thefollowing claims.

What is claimed as new and desired to be secured by Letters Patent is:

1. In a surgical control device, the combination of a bendable shaperetaining non-elastic tubular guide means composed substantially ofsilver; an elongated instrument control means passing through saidtubular guide means and being movable relative thereto; and at least onecoil spring means composed of non-magnetizable material tightly engagingsaid tubular guide means along the length thereof, said coil springmeans having the ends thereof respectively connected to the ends of saidtubular guide means, whereby said bendable tubular guide means can berepeatedly bent between different desired curved positions without beingdamaged, to remain relatively rigid in a desired bent condition.

2. In a surgical control device, the combination of a bendable shaperetaining tubular guide means of nonelastic material having a pair ofopposite ends and an intermediate flattened tubular portion intermediateand spaced from said ends; an elongated instrument control means passingthrough said tubular guide means and being movable relative thereto; andcoil spring means tightly engaging the outer wall of said tubular guidemeans along the length thereof, whereby said bendable tubular guidemeans can be repeatedly bent between different desired curved positionswithout being damaged, while re; maining relatively rigid in a desiredbent condition.

3. In a surgical control device, the combination of a bendable shaperetaining tubular guide means of nonelastic material having a pair ofopposite ends and an intermediate flattened tubular portion intermediateand spaced from said ends; an elongated instrument control means passingthrough said tubular guide means and being movable relative thereto; andcoil spring means tightly engaging the outer wall of said tubular guidemeans along the length thereof, said coil spring means having the endsthereof respectively connected to said ends of said tubular guide meanswhereby said bendable tubular guide means can be repeatedly bent betweendifferent desired curved positions without being damaged, whileremaining relatively rigid in a desired bent condition.

4. In a surgical control device, the combination of a bendable tubularguide means composed substantially of silver and having a pair ofopposite ends and an intermediate flattened tubular portion intermediateand spaced from said ends; an elongated instrument control means passingthrough said tubular guide means and being movable relative thereto,said control means including a flattened portion located adjacent saidflattened portion of said guide means; and coil spring means tightlyengaging the outer wall of said tubular guide means along the lengththereof, said coil spring means having the ends thereof respectivelyconnected to said ends of said tubular guide means, whereby saidbendable tubular guide means can be repeatedly bent between differentdesired curved positions without being damaged.

5. In a surgical control device, the combination of a bendable shaperetaining tubular guide means of nonelastic material; an elongatedinstrument control means passing through said tubular guide means andbeing movable relative thereto; and a pair of coil spring means, saidcoil spring means respectively tightly engaging the inner wall and theouter wall of said tubular guide means along the length thereof, wherebysaid bendable tubular guide means can be repeatedly bent betweendifferent desired curved positions without being damaged, while remain-1ng relatively rigid in a desired bent condition.

6. In a surgical control device, the combination of a bendable shaperetaining tubular guide means of nonelastic material; an elongatedinstrument control means passing through said tubular guide means andbeing mova ble relative thereto; and a pair of coil spring means, saidcoil spring means respectively tightly engaging the inner wall and theouter wall of said tubular guide means along the length thereof, each ofsaid coil spring means having the ends thereof respectively fixedlyconnected to the ends of said tubular guide means, whereby said bendabletubular guide means can be repeatedly bent between different desiredcurved positions without being damaged, while remaining relatively rigidin desired bent condition.

7. In a surgical control device, the combination of a bendable shaperetaining tubular guide means composed substantially of silver; anelongated instrument control means passing through said tubular guidemeans and being movable relative thereto, said control means having atone end a threaded portion for interchangeably connecting said controlmeans with operating means and at the opposite end a joint portion forinterchangeably connecting said control means with manually operablemeans for controlling said operating means; and a pair of coil springmeans, said coil spring means respectively tightly engaging the innerwall and the outer wall of said tubular guide means along the lengththereof, each of said coil spring means having the ends thereofrespectively fixedly connected to the ends of said tubular guide means,whereby said bendable tubular guide means can be repeatedly bent betweendifferent desired curved positions without being damaged, whileremaining relatively rigid in a desired bent condition.

8. In a surgical control device, the combination of elongated guidemeans including a bendable shape retaining tubular member of non-elasticmaterial having a first cylindrical end portion and a second cylindricalend portion, and a pair of end members respectively adjacent said endportions, each of said end members having a cylindrical surface portionengaging said respectively adjacent end portions circumferentially' andan end face abutting respectively the end faces of said respectivelyadjacent end portions, each of said end members having at least oneradially extending stop portion; an elongated instrument control memberpassing through said guide means and being movable relative thereto,said control member having a first end portion adapted to be connectedto operating means and a second end portion adapted to be connected tomanually operable means for controlling said operating means, said firstend portion of said control member extending axially beyond said firstend portion of said tubular member and said second end portion of saidcontrol member extending axially beyond the end member adjacent saidsecond end portion of said tubular member, said control member havingnear said second end portion thereof a thicker cylindrical portion ofthe outer wall of which contacts the inner wall of said second endportion of said tubular member and the inner wall of the adjacent endmember so that movement of said control member is guided; and at leastone coil spring having the ends thereof respectively connected to saidstop portions of said end members, said coil spring tightly engaging awall of said tubular member along the length thereof, whereby saidbendable tubular member can be repeatedly bent between difierent desiredcurved positions without being damaged, while remaining in a desiredbent condition.

References Cited in the file of this patent UNITED STATES PATENTS2,165,414 Riddell July 11, 1939 FOREIGN PATENTS 609,894 France May 22,1926 108,322 Austria Dec. 27, 1927

